将戒烟纳入创伤后应激障碍的心理健康护理:一个随机对照试验
Miles McFall1, Andrew J Saxon, Carol A Malte
1Veterans Affairs Puget Sound Health Care System, 1660 S Columbian Way, S-116 MHC, Seattle, WA 98108, USA. miles.mcfall@va.gov
JAMA
|December 9, 2010
概括
将戒烟治疗整合到患有创伤后应激障碍 (PTSD) 的退伍军人心理健康护理中,显著改善了长期戒烟率. 这种方法比向戒烟诊所的标准转诊更有效.
科学领域:
- 心理健康 心理健康
- 成 药物 药物 药物 药物
- 临床试验 临床试验
背景情况:
- 大多数患有精神疾病的吸烟者,包括创伤后应激障碍 (PTSD),都没有接受足够的戒烟治疗.
- 患有军方相关PTSD的退伍军人代表了吸烟率很高和大量未满足的戒烟支持需求的人群.
研究的目的:
- 评估将戒烟治疗整合到患有PTSD的退伍军人的日常心理健康护理中的有效性.
- 为了比较综合护理和标准转诊到戒烟诊所之间的长期戒烟率.
主要方法:
- 一项随机对照试验涉及943名吸烟者,他们从10个退伍军人事务医疗中心招募了与军事有关的PTSD.
- 参与者被随机分配到由心理健康临床医生提供的综合护理 (IC) 或转诊到专门的戒烟诊所 (SCC).
- 随访时间从18个月延长到48个月,结果包括12个月生物验证的长期戒断和每3个月间隔的点患病率戒断.
主要成果:
- 与SCC相比,综合护理的长期戒断率 (8.9%) 显著更高 (4.5%;调整后的几率比,2.26;P = .004).
- 禁欲7天点患病率的差异在6个月 (16.5%对7.2%) 显著,并在18个月 (18.2%对10.8%) 保持显著.
- 咨询会议和药物治疗日数占治疗效果的39.1%,在任何一组中,精神病状况没有显著恶化.
结论:
- 将戒烟治疗纳入患有PTSD的退伍军人心理健康护理是改善长期戒烟的有效策略.
- 这种综合模型提供了一种有希望的方法来解决这一弱势群体的烟草使用问题.
- 戒烟与参与者的心理健康状况改善或稳定有关.
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